Nurse Practitioner Education Research Articles

Expanding rural access to mental health care through online postgraduate nurse practitioner education.

Workforce shortages in mental health care are especially relevant to rural communities. People often turn to their primary care providers for mental healthcare services, yet primary care providers indicate that more education is needed to fill this role. Rural primary care nurse practitioners (NPs) are ideal candidates for educational enhancement. Online programs allow NPs to continue living and working in their communities while developing the competencies to provide comprehensive and integrated mental healthcare services. This article presents a review of current online postgraduate psychiatric mental health NP (PMHNP) options. Website descriptions of online PMHNP programs were located using keywords: PMHNP or psychiatric nurse practitioner, postgraduate or post-master's, and distance or online. Across the United States, 15 online postgraduate certificate programs were located that are designed for primary care NPs seeking additional PMHNP specialization. For rural primary care NPs who are ready, willing, and able, a postgraduate PMHNP specialty certificate can be obtained online in as few as three to four semesters. The expected outcome is a cadre of dually credentialed NPs capable of functioning in an integrated role and of increasing rural access to comprehensive mental healthcare services.

Broadening the Reach of Standardized Patients in Nurse Practitioner Education to Include the Distance Learner.

Using standardized patients (SP) presenting with a specific complaint has been a mainstay in health care education. Increased use of technology has facilitated the move of instruction from the on-campus classroom to distance learning for many nurse practitioner programs. Using interactive case studies provides distance learners SP encounters. This technologically facilitated encounter gives the distance learner the opportunity for integrative thinking and development of problem solving and clinical reasoning skills.

Competency Development to Support Safe Nurse Practitioner Prescribing of Controlled Drugs and Substances in British Columbia

In 2012, Canada passed legislation giving nurse practitioners (NPs) authority to prescribe controlled drugs and substances. Steps toward safe implementation by the nursing regulatory body in British Columbia included development of controlled drugs and substances prescribing competencies for use in educating and authorizing NPs for this new scope. In this article, we discuss the development and refinement of the competencies, specifically their application to nursing regulation in British Columbia. Methods include incorporation of the Competency Outcome Performance Assessment Model as a guiding theoretical framework. Over two meetings in 2014, a small representative panel of health professionals completed face and content validation of 17 initial competencies using a visual Likert-type scale ranking process (1-5, unnecessary to essential) with Google Docs for real-time comparative refinement. The resulting 10 competency statements provide the foundation for outcome indicator development which will be used in NP education and the regulatory body's regulation and remediation processes. Finally, we describe the policy process applied to implement competencies for NP controlled drugs and substances prescribing and the subsequent challenges of implementation of controlled drugs and substances authority in British Columbia. The article concludes with an overview of lessons learned that may be beneficial to health professions regulatory bodies introducing or expanding prescribing scope for NPs.

Assessing abortion coverage in nurse practitioner programs in Canada: a national survey of program directors

ObjectivesAlthough nurse practitioners (NPs) play a critical role in the delivery of reproductive health services in Canada, there is a paucity of published information regarding the reproductive health education provided in their training programs. Our study aimed to understand better the didactic and curricular coverage of abortion in Canadian NP programs. Study designIn 2014, we conducted a 3-contact, bilingual (English–French) mailed survey to assess the coverage of, time dedicated to and barriers to inclusion of 17 different areas of reproductive health, including abortion. We also asked respondents to speculate on whether or not mifepristone would be incorporated into the curriculum if approved by Health Canada for early abortion. We analyzed our results with descriptive statistics and used inductive techniques to analyze the open-ended questions for content and themes. ResultsSixteen of 23 (70%) program directors or their designees returned our survey. In general, abortion-related topics received less coverage than contraception, ectopic pregnancy management and miscarriage management. Fifty-six percent of respondents reported that their program did not offer information about first-trimester abortion procedures and/or post-abortion care in the didactic curriculum. Respondents expressed interest in incorporating mifepristone/misoprostol into NP education and training. ConclusionReproductive health issues receive uneven and often inadequate curricular coverage in Canadian NP programs. Identifying avenues to expand education and training on abortion appears warranted. Embarking on curricular reform efforts is especially important given the upcoming introduction of mifepristone into the Canadian health system for early abortion. ImplicationsOur findings draw attention to the need to integrate abortion-related content into NP education and training programs. The approval of Mifegymiso® may provide a window of opportunity to engage in curriculum reform efforts across the health professions in Canada.

Educational Changes to Support Advanced Practice Nursing Education.

Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system.

Improving the Education and Training of Primary Care Nurse Practitioners to Meet the Healthcare Needs of Long-Term Cancer Survivors.

The United States has a well-documented shortage of primary care providers (PCPs) and oncologists. Cancer survivors are living longer because of advances in treatment, and, consequently, more are seeking survivorship care from PCPs; this trend is predicted to continue. One proposed solution is to increase the use of nurse practitioners (NPs). However, most NP programs do not provide adequate training or education that is specific to the needs of long-term cancer survivors.&nbsp.

Understanding scoping reviews: Definition, purpose, and process.

Scoping review design represents a methodology that allows assessment of emerging evidence, as well as a first step in research development. Despite its increasing use, to date no article reflecting use of scoping review methodology has been submitted for review at JAANP. The purpose of this article is to provide detailed information on scoping reviews, including definition, related processes, and uses, and discuss the relationship to nurse practitioner (NP) practice, policy, education, and research. The longer-term goal is that NPs will understand the related techniques, consider the methodology as a viable one for NP scholarship, and bring related reports to the forefront of NP publications. This manuscript represents a brief report. Processes to develop the brief include detailed search and review of scoping review literature in CINAHL and PubMed. Both methodologic reports and reviews were included. Definitions and uses of scoping reviews were reviewed. The definition and process of scoping review are evolving. Although there is controversy regarding the methodology, there is increasing visibility of scoping review methodology in the published literature since the year 2000, with over 500 published reviews currently available. A well-executed scoping review has potential to inform NP practice, policy, education, and research.

Educating for health service reform: clinical learning, governance and capability - a case study protocol.

BackgroundThe nurse practitioner is a growing clinical role in Australia and internationally, with an expanded scope of practice including prescribing, referring and diagnosing. However, key gaps exist in nurse practitioner education regarding governance of specialty clinical learning and teaching. Specifically, there is no internationally accepted framework against which to measure the quality of clinical learning and teaching for advanced specialty practice.MethodsA case study design will be used to investigate educational governance and capability theory in nurse practitioner education. Nurse practitioner students, their clinical mentors and university academic staff, from an Australian university that offers an accredited nurse practitioner Master’s degree, will be invited to participate in the study.Semi-structured interviews will be conducted with students and their respective clinical mentors and university academic staff to investigate learning objectives related to educational governance and attributes of capability learning. Limited demographic data on age, gender, specialty, education level and nature of the clinical healthcare learning site will also be collected. Episodes of nurse practitioner student specialty clinical learning will be observed and documentation from the students’ healthcare learning sites will be collected.Descriptive statistics will be used to report age groups, areas of specialty and types of facilities where clinical learning and teaching is observed. Qualitative data from interviews, observations and student documents will be coded, aggregated and explored to inform a framework of educational governance, to confirm the existing capability framework and describe any additional characteristics of capability and capability learning.DiscussionThis research has widespread significance and will contribute to ongoing development of the Australian health workforce. Stakeholders from industry and academic bodies will be involved in shaping the framework that guides the quality and governance of clinical learning and teaching in specialty nurse practitioner practice. Through developing standards for advanced clinical learning and teaching, and furthering understanding of capability theory for advanced healthcare practitioners, this research will contribute to evidence-based models of advanced specialty postgraduate education.

Promoting Access Through Integrated Mental Health Care Education.

Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students.

Role Development of Nurse Practitioners and Physician Assistants in Liver Transplantation.

Nurse practitioners (NPs) and physician assistants (PAs) are increasingly utilized in health care. However, their roles in liver transplantation (LT) have not been investigated. In this study, we reviewed the employment and development of NPs and PAs and their impact on our deceased-donor LT (DDLT) program. We found a safe and efficient way to utilize NPs and PAs in a DDLT program. Since the beginning of our program, Model of End-Stage Liver Disease (MELD) scores have increased significantly, suggesting patients are sicker at the time of transplant, and wait times of patients have become longer. With the incorporation of NPs and PAs, we found that length of stay (LOS) was not affected. The overall median warm ischemic time did not increase. Outcomes of LT for both patient and graft survival actually improved and remain at or above the expected values. These results collectively support the usefulness and validity of NPs and PAs in a DDLT program. We have determined that surgical and medical NPs and PAs are essential for optimal patient outcomes. They facilitate a better learning experience for residents and fellows on their transplant rotations. Further investigations to assess the roles of these providers and their impact on the education of residents and fellows in transplantation are warranted. Further transplant hepatology education programs and/or fellowships are recommended to assist in the education and professional development of transplant NPs and PAs.

Expanding the Use of Simulation in Nurse Practitioner Education: A New Model for Teaching Physical Assessment

Nurse practitioner students in their first clinical semester must practice performing health histories and physical assessments, and develop diagnostic reasoning skills. The development of these skills is often dependent on the availability and teaching readiness of the clinical preceptor. This article describes a different model for teaching assessment skills and for mentoring new nurse practitioner students. The course was conducted in a simulated clinic setting biweekly throughout the semester, using coordinated cases with simulated patients (SPs). The students take an active role in assessing SPs with consistent oversight and immediate feedback from faculty, peers, and SPs.

Postgraduate Nurse Practitioner Education: Impact on Job Satisfaction

Programs to facilitate nurse practitioner (NP) transition-to-practice have been developed at public and private institutions across the United States, yet there is no published evidence of their influence on NP job satisfaction. The Misener Nurse Practitioner Job Satisfaction Scale was administered to a convenience sample of two groups of NPs: one group with a formal postgraduate education and another group without formal postgraduate education. Postgraduate education has a statistically significant positive impact on NP job satisfaction. Knowledge of factors that influence job satisfaction is advantageous to employers, policymakers, and NPs considering postgraduate education opportunities.

Sport-Related Concussion in Youth: A Curriculum for Advanced Practice Nurses

Sports-related concussions are a major public health concern for children, parents, and health care providers. Effective management of sports-related concussions in children and adolescents requires timely and accurate diagnosis and appropriate management. Advance practice nursing textbooks often do not address sport-related concussions. Although nurse practitioners routinely care for these patients, they may not have adequate education or training to diagnose and manage them. It is essential to close the gap in education by providing up-to-date recommendations and guidelines for diagnosis and management. Current research and recommendations are presented to facilitate nurse practitioner education about sport-related concussion.

Cultivating the Role of Nurse Practitioners in Providing Primary Care to Vulnerable Populations in an Era of Health-Care Reform.

The evolving role of nurse practitioners (NPs) as primary care providers, especially for vulnerable populations, is central to the debate regarding strategies to address the growing need for primary care services. The current article provides policy recommendations for leveraging and expanding the historic role of NPs in caring for vulnerable populations, by focusing on three key policy levers: NP scope-of-practice regulation, distribution of the NP workforce, and NP education. These policy levers must go hand in hand to build a sufficient and equitably distributed NP workforce, to help meet the escalating need for primary care in an era of health-care reform.

Nurse practitioner and physician assistant students' knowledge, attitudes, and perspectives of chiropractic.

The purpose of this study was to assess nurse practitioner (NP) and physician assistant (PA) students' views of chiropractic. As the role of these providers progresses in primary care settings, providers' views and knowledge of chiropractic will impact interprofessional collaboration and patient outcomes. Understanding how NP and PA students perceive chiropractic may be beneficial in building integrative health care systems. This descriptive quantitative pilot study utilized a 56-item survey to examine attitudes, knowledge, and perspectives of NP and PA students in their 2nd year of graduate studies. Frequencies and binomial and multinomial logistic regression models were used to examine responses to survey totals. Ninety-two (97%) students completed the survey. There were conflicting results as to whether participants viewed chiropractic as mainstream or alternative. The majority of participants indicated lack of awareness regarding current scientific evidence for chiropractic and indicated a positive interest in learning more about the profession. Students who reported prior experience with chiropractic had higher attitude-positive responses compared to those without experience. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice. The results of this study emphasize the need for increased integrative initiatives and chiropractic exposure in NP and PA education to enhance future interprofessional collaboration in health care.

Nurse Practitioners' Use of Communication Techniques: Results of a Maryland Oral Health Literacy Survey.

ObjectivesWe examined nurse practitioners’ use and opinions of recommended communication techniques for the promotion of oral health as part of a Maryland state-wide oral health literacy assessment. Use of recommended health-literate and patient-centered communication techniques have demonstrated improved health outcomes.MethodsA 27-item self-report survey, containing 17 communication technique items, across 5 domains, was mailed to 1,410 licensed nurse practitioners (NPs) in Maryland in 2010. Use of communication techniques and opinions about their effectiveness were analyzed using descriptive statistics. General linear models explored provider and practice characteristics to predict differences in the total number and the mean number of communication techniques routinely used in a week.ResultsMore than 80% of NPs (N = 194) routinely used 3 of the 7 basic communication techniques: simple language, limiting teaching to 2–3 concepts, and speaking slowly. More than 75% of respondents believed that 6 of the 7 basic communication techniques are effective. Sociodemographic provider characteristics and practice characteristics were not significant predictors of the mean number or the total number of communication techniques routinely used by NPs in a week. Potential predictors for using more of the 7 basic communication techniques, demonstrating significance in one general linear model each, were: assessing the office for user-friendliness and ever taking a communication course in addition to nursing school.ConclusionsNPs in Maryland self-reported routinely using some recommended health-literate communication techniques, with belief in their effectiveness. Our findings suggest that NPs who had assessed the office for patient-friendliness or who had taken a communication course beyond their initial education may be predictors for using more of the 7 basic communication techniques. These self-reported findings should be validated with observational studies. Graduate and continuing education for NPs should increase emphasis on health-literate and patient-centered communication techniques to increase patient understanding of dental caries prevention. Non-dental healthcare providers, such as NPs, are uniquely positioned to contribute to preventing early childhood dental caries through health-literate and patient-centered communication.

Postgraduate Nurse Practitioner Education: Impact on Job Satisfaction

Postgraduate Nurse Practitioner Education: Impact on Job Satisfaction

Development of The Johns Hopkins University School of Nursing Adult/Geriatric Primary Care Nurse Practitioner Program in HIV Prevention, Treatment, and Care

In response to the call to create an AIDS Education and Training Center for Nurse Practitioner Education by the Health Resources and Services Administration, The Johns Hopkins University School of Nursing embarked on a transformative curriculum overhaul to integrate HIV prevention, treatment, and care into the Adult/Geriatric Nurse Practitioner Program. A six-step process outlined in the Curriculum Development for Medical Education was followed. A pilot cohort of Adult/Geriatric Nurse Practitioner students were enrolled, including 50% primary care setting and 50% HIV-focused primary care through a 12-month HIV continuity clinic experience. Through this pilot, substantive changes to the program were adopted. Programmatic outcomes were not compromised with the modification in clinical hours. The model of a 12-month HIV continuity clinical experience reduced the number of required preceptors. This model has important implications for the HIV workforce by demonstrating successful integration of HIV and primary care training for nurse practitioners.

Online nurse practitioner education: Achieving student competencies.

This review article will describe the methods used in a fully online NP program with curricular framework based on experiential and adult learning theories using problem-based learning. The focus is on faculty facilitation, preceptor preparation, student evaluation, and the development of engaging clinical partnerships.

Management of Postoperative Pediatric Patients

OPEN ACCESSOctober 27, 2015Management of Postoperative Pediatric Patients Karen Jerardi, MD, MEd, Katie Meier, MD, Erin Shaughnessy, MD Karen Jerardi, MD, MEd Cincinnati Children's Hospital Medical Center Google Scholar More articles by this author , Katie Meier, MD Cincinnati Children's Hospital Medical Center Google Scholar More articles by this author , Erin Shaughnessy, MD Cincinnati Children's Hospital Medical Center Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.10241 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: According to a 2013 study of career intents, 12% of graduating pediatric residents pursue careers in pediatric hospital medicine, often without additional fellowship training. Increasingly, pediatric hospitalists are asked to help comanage postoperative patients. There is a lack of evidence-based curricula in the management of the postoperative pediatric patient. Recently, the American Academy of Pediatrics Section on Hospital Medicine Surgical Care Subcommittee has identified the need for such curricula as a priority. As a result, the education co-leads for the subcommittee have teamed together with the director of fellowship, resident elective, and advanced practice nurse practitioner education for the Division of Hospital Medicine at Cincinnati Children's to develop this curriculum. Content for this curriculum was chosen based on a needs assessment of recent pediatric residency graduates and practicing pediatric hospitalists, who selected high-yield topics. Methods: The resource was developed by pediatric hospital medicine faculty who focus on the care of the postoperative pediatric patient and includes 11 narrated PowerPoint presentations. Each module contains learning objectives and questions for review. The modules together provide a background of the most common issues that arise in the care of the pediatric postoperative population. The modules can be used as a stand-alone resource or to augment a clinical rotation. Results: The resource has been used for a variety of providers, including pediatric residents, pediatric hospital medicine fellows, faculty, and nurse practitioners. Evaluations from each learner have been collected, and appropriate changes have been made to enhance the curriculum. Outcomes were measured using time spent reviewing the modules, as measured by the learning platform used to store the modules, and self-assessments from the learners. Average time spent accessing the modules was 5.5 hours, with a range of 2-16.5 hours. Learners completed an anonymous evaluation rating the modules and their overall response to the curriculum. Overall, 100% stated that the presentations did “inform your care” of patients, 90% felt the presentations increased their comfort level for caring for surgical patients, and 100% would recommend the curriculum to a colleague. Discussion: There are currently no published curricula addressing topics commonly encountered during the care and co-management of postoperative pediatric patients. This resource was developed by pediatric hospital medicine faculty in response to this vacancy. Educational Objectives At the conclusion of the activity, the participant will: Recognize a typical postoperative course and anticipate complications for pediatric surgical patients.Report increased knowledge and comfort in caring for pediatric surgical patients. ReferencesBaker RC, Klein M, Samaan Z, Lewis K. Effectiveness of an online pediatric primary care curriculum, Acad Pediatr.2010;10(2):131–137. http://dx.doi.org/10.1016/j.acap.2009.12.004Medline, Google ScholarCox ED, Koscik RI, Olson CA, et al. 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Pediatric hospital medicine worklife: findings from the American Academy of Pediatrics 2012-13 survey. Presented at: the Annual Meeting of the Society of Hospital Medicine; March 24-27, 2014; Las Vegas, NV.Google ScholarSimon TD, Eilert R, Dickinson LM, Kempe A, Benefield E, Berman D. Pediatric hospitalist comanagement of spinal fusion surgery patients, J Hosp Med.2007;2(1):23–30. http://dx.doi.org/10.1002/jhm.144Medline, Google Scholar Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Postoperative Pediatric Patients Instructor's Guide.docx Venous Thromboembolism.pptx Shunt Malfunction.pptx Posterior Spinal Fusion.pptx Postoperative Anemia.pptx Postoperative Ileus.pptx Postoperative Tachycardia.pptx Postoperative Fever.pptx Syndrome of Inappropriate Anti-Diuretic Hormone Secretion.pptx Postoperative Nutrition.pptx Postoperative Pain.pptx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationJerardi K, Meier K, Shaughnessy E. Management of Postoperative Pediatric Patients. MedEdPORTAL. 2015;11:10241. https://doi.org/10.15766/mep_2374-8265.10241 Copyright & Permissions© 2015 Jerardi et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsPediatricsSurgical ComanagmentHospital Medicine Disclosures None to report. Funding/Support None to report. tabs.loading